Provider Demographics
NPI:1407033541
Name:HORIZON MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:HORIZON MEDICAL TRANSPORTATION
Other - Org Name:D & E HORIZON HEALTH CARE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DIVINE
Authorized Official - Middle Name:BERINYUY
Authorized Official - Last Name:JIMLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-442-1801
Mailing Address - Street 1:6428 LANDING WAY
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4619
Mailing Address - Country:US
Mailing Address - Phone:301-442-1801
Mailing Address - Fax:301-306-0726
Practice Address - Street 1:6428 LANDING WAY
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4619
Practice Address - Country:US
Practice Address - Phone:301-442-1801
Practice Address - Fax:301-306-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCWMATC # 1145343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)